ClickCare Café

The Simple Truth about Collaboration in Medicine

Posted by Lawrence Kerr on Thu, Aug 16, 2018 @ 07:00 AM

rawpixel-703123-unsplashMany people love science and medicine for the exciting stuff: the cutting-edge research, the dramatic diagnoses, the high-tech equipment.

The truth, though, is that medicine actually happens in a much subtler, more incremental way. It’s quiet moments with a patient or busy weeks when we see hundreds of patients but without any "big cases." Real medicine is simpler and less outwardly impressive than people may think. 

Similarly, healthcare collaboration is more steak than sizzle. And a recent article about a collaborative institution in Europe reminded me of these fundamentals. 

Robert Klaber, MD is a pediatrician who works at the Imperial College Health Care NHS Trust. The organization serves 2 million patients in Northwest London, with a staff of 11,000. He wrote a phenomenal article sharing his experience of collaboration in London -- bold work that is both more commonsensical, simpler, and more impactful than so much of what we read about healthcare collaboration. 

As he explains, “If you talk to patients, they will often tell you they receive poor care or their needs aren’t met when they fall between different providers. Support for patients often isn’t joined up, so it’s crucial that we collaborate much more thoughtfully. Unfortunately, the levers in the system still point away from that.”

He sees collaboration as even more than just provider-to-provider conversations. It's also about collaboration with the community they serve. "As we start to move [away] from a model of fixing illness toward one focused on health and wellbeing, our old methods just don’t stack up. We need to learn from the people and parts of society that have been doing more of this than health care."

The common way to think about healthcare collaboration is unidimensional (one specialist speaking to another on videoconferencing) but also tech-heavy and expensive. What I love about this article is that Dr. Klaber is thinking about collaboration in ways that are both more simple and more expansive than people normally do. 

Dr. Klaber sees collaboration as creative, dynamic connection that might not need special tools. Just as in our town of Binghamton NY, we did cutting-edge multidisciplinary cranio-facial team meetings (which involved no more complicated technology than a round table and some donuts), Dr. Klaber is doing multidisciplinary team meetings to talk holistically about pediatric cases -- with great and measurable results. 

So to me, the question is simply -- what can we envision for creative, multidirectional collaboration? And what are the simplest tools we can use to make that vision become real?

We're so passionate about iClickCare because it's a very affordable and easy-to-use tool that facilitates multidirectional and multidisciplinary collaboration. But other collaboration tools can include a simple conversation, a box of donuts, or a smile. 

As Dr. Klaber emphasizes, metrics are important but "It’s more important that we sustainably develop a workforce who has a sense of meaning and purpose, and the skills to do what our patients need us to do... [And] How do we start to deliver outcomes that really matter to patients, and aren’t just a traditional, often hospital-based process that we’ve had in place since Victorian times? Better collaboration could help with all these priorities."

Get inspired with more stores of medical collaboration here: 

ClickCare Quick Guide to Medical Collaboration

Tags: healthcare collaboration software, medical collaboration tool

Why Limiting Access to the Medical System May Be a Good Thing

Posted by Lawrence Kerr on Wed, Aug 15, 2018 @ 07:00 AM

masaaki-komori-601781-unsplashI’ll be the first to say that our medical system, despite its flaws, is miraculous.

The care that healthcare providers give on a day-to-day basis, in terms of complexity and art and compassion is astounding, especially when we look at how far we’ve come in the last 100 years.

That said, the evidence is mounting that in many ways, the negative effects of contact with the healthcare system are significant. Are they usually are out weighed by the benefits of accessing healthcare? Certainly. But just as every drug has its side effects, the side effects of medical visits and hospital stays themselves are becoming more obvious and quantified.

So does healthcare really have a negative impact on health?

I think there is strong evidence that it does. For instance, this article on “post hospital syndrome” raises the point that hospital stays can be extremely damaging to the overall health of patients, especially the elderly. While the stays tend to treat the original illness, there is observed to be a significant impact on the patient's overall health, wellness, and independence.

In fact, post-hospital syndrome seems to be a cause of the very high readmission rates among older people. In 2016, about 18 percent of discharged Medicare beneficiaries returned to the hospital within 30 days, according to the federal Centers for Medicare and Medicaid Services.

Dr. Harlan Krumholz, a cardiologist at Yale University, has been looking at the reasons for this. When he looked at 30-day readmissions, he found that many causes of readmissions had nothing to do with the initial admission. “Patients came in with heart failure or pneumonia, were treated and discharged, then returned with internal bleeding or injuries from a fall. ‘Our general approach in a hospital is, all hands on deck to deal with the problem people come in with,’ Dr. Krumholz said. ‘All the other discomforts are seen as a minor inconvenience.’”

But the other discomforts can be incredibly serious when it comes to health and recovery after an illness. Dr. Krumholz is finding that simple things that keep patients’ lives as normal as possible even when hospitalized can have a big impact — walks down the corridor, wearing their clothes, eating normal foods, etc. These things can make it so that muscle loss, cognitive degradation, confusion, balance issues, and the like are all mitigated.

Solutions are mimicking regular life. But the only thing better than that is actual regular life -- keeping people out of the hospital, or even away from a doctor's office, as much as possible.

Similarly, outside of an inpatient context, we tend to refer and set appointments as if the transportation isn’t a relevant concern. But as this article explores, healthcare transportation can be a major impediment to care, a huge expense, and a important disruption to the patient’s life.

Each contact with the medical system comes at a cost. These costs can come in the form of money, transportation, and a negative impact on the things that keep people healthy and happy. And so many times, our patients don't need to be interacting with the healthcare system nearly as much as they do. A referral to a second provider, with its accompanying visit (and long drive, and a day off work or play), could easily be replaced by a quick consult with a tool like iClickCare. A hospital visit may be able to be shortened by 30% if the providers on the case had a quick way to touch base on the patient's status. Hopping between doctors for different diagnosis perspectives can be replaced by team-based medical collaboration (like hybrid store-and-forward® telemedicine.)

So what are providers to do? My opinion is that when healthcare providers work together more, patients need to interact with the healthcare system less. The truth is that when we are able to collaborate effectively, we dramatically cut down on length of stay, total number of medical visits, and time spent in a medical setting.

Evidence shows that home, and regular life, is where people heal. So let’s work together so our patients can spend more time there -- and less time in a hospital bed or in a doctor's office.

 

iClickCare is a simple way to cut length of stay and even visits. You can try it for free here: 

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Tags: healthcare collaboration, decrease readmissions, decrease length of stay

Do Women Doctors Experience Gender Bias or Is It a Thing of The Past?

Posted by Lawrence Kerr on Wed, Aug 08, 2018 @ 10:58 AM

rawpixel-675359-unsplashAs you may know, our cofounder was one of five women in her medical school class.

She’s a tremendous doctor, bringing compassion, strong instincts, and impeccable skill to the challenging field of pediatrics.

But she didn't have it easy along the way. She certainly experienced gender bias (to put it lightly) over the span of years. She thrived despite challenging conditions around her, and became a leader in medicine.

So as I flipped through the New England Journal of Medicine recently, a chart caught my eye. It showed women as a percentage of matriculants in US medical schools -- from 10% in 1955 to about 50% in 2017. Which had me wondering -- is gender bias a thing of the past for women in medicine? And what does it mean for our teams that the percentages of male and female doctors are changing so dramatically?

In "Recognizing Blind Spots - A Remedy for Gender Bias in Medicine?" Loren Rabinowitz, MD looks at the question of how gender bias functions in medicine. She cites data, both personal and quantitative, demonstrating that despite the changing numbers, gender bias and even sexual harassment are common in the medical workplace for women. And, women are underrepresented in leadership positions in medical schools and hospitals.

That said, she also points to data showing the richness that women bring to the medical field. One study, for instance, shows that patients treated by female doctors have better outcomes than those treated by male doctors. 

In some ways, I notice that this changing landscape starts to make it feel like a competition for scarce resources among male providers and female providers. Does the growth of women in medicine -- past, present, and future -- come at a cost for men in medicine? It's a divisive question to ask, but I believe that it underlies many people's actions and is worth bringing to the surface.

My take? It’s in our interest to make sure that we don’t have a “zero sum” mindset. Women having a safe and respectful workplace for their practice of medicine doesn’t detract from men’s experience. In fact, strong medical teams depend on a diversity of opinions, experiences, and skill sets. And the truth is that our personal background (including race, gender, nationality, etc.) is big part of the experience and opinions that we bring to the table. When we create an environment that values these differences, rather than seeking to minimize them, our practice of medicine becomes richer and more nuanced.

Beyond just ensuring gender equity in medicine, I believe that it's important to look at the issue more broadly. Effective healthcare collaboration demands that we are respectful of all of the voices on our medical team. But this requires more than good intentions -- it requires that we have the appropriate tools to enable teams to truly collaborate, not just fit in with the hierarchy. If you don't use telemedicine for healthcare collaboration, I encourage you to think about what tools you do have to encourage the team to collaborate in all its diversity -- and in all its strength.

 

ClickCare Quick Guide to Medical Collaboration

 

Tags: coordinated care, healthcare collaboration software

Why Telemedicine Can Help You Make Better Medical Decisions

Posted by Lawrence Kerr on Thu, Aug 02, 2018 @ 07:00 AM

michal-parzuchowski-43274-unsplashAnnie Duke is an author, consultant, and former professional poker player. In other words, she studies good decisions for a living.

Medicine, of course, is about far more than good decisions. It’s about compassion, leadership, science, and training. But excellent decisions — in both diagnosis and treatment plans — are absolutely crucial for providing excellent care. So I was intrigued to read an article recently, in my investment journal of all places, that made me think a lot about decisions and how we can make them better as healthcare providers.

The article, "Making Better and More Rational Decisions. An interview with Annie Duke," in the American Association of Individual Investors Journal, is a compelling piece with applications for life and investment, certainly. 

But what fascinated me were the implications for healthcare providers, trying to make the best possible decisions they can. Further, I noticed that many of Annie's points boiled down to getting better information or bringing others in on your decision -- both of which are deeply supported by hybrid store-and-forward telemedicine, when it comes to medical decisions. 

3 Fascinating Decision-Making Tips for Healthcare from Decision Expert and Pro Poker Player Annie Duke:

1. Remove emotion from the decision. 
We don't think about medical decisions as having an emotional component, but the truth is that they do. It's not unusual to get caught up in all of the details of a case, feel an emotional reaction to a patient, or otherwise let emotion creep into the decision-making process. Annie Duke says that predicting downsides is core to the decision-making process. And that predicting downsides is easier when you’re not emotionally involved -- which means that our colleagues' unbiased opinion is often crucial to a good decision. It's the reason that "bouncing an idea off" someone is such a common way to approach a decision -- but we have to have the tools in place to quickly and easily bounce ideas off colleagues, even when they're not just down the hall. That's what a consult via a telemedicine solution can do for you.


2. Bring in people with different experiences and views than you have.
That will lead to a better decision. “It’s especially important to seek out opinions that disagree with you. This is because we naturally notice things that do agree with us, and we already know why we think that way.”  Hybrid store-and-forward telemedicine is the most powerful way of truly engaging a team approach to telemedicine. Since you can quickly, easily, and asynchronously collaborate with people on the medical team across the continuum of care, it's not hard to bring in people with diverse experiences, views, and expertise than you have. These providers, who may not agree with your initial ideas, can help us make dramatically better decisions on behalf of our patients. 

3. Learn from past decisions. 
Learning from past decisions is crucial. It lets you take in new information, learn lessons from cases that didn't have the outcome you anticipated, as well as help our students or colleagues make better decisions by learning from our experiences. That's why every case in iClickCare is archived and searchable -- it's a realtime learning tool for making better medical decisions, now and in the future. 

 

Ultimately, good medical outcomes come from good medical decisions. These decisions may be large or small, but their sum contributes to the patient's outcome. So any tool that can help us make better decisions, may be critical to good care. That's one reason we're so passionate about our work with iClickCare -- and a reason to try it if you haven't already. 

 

Try the iClickCare 14-day evaluation

 

Tags: care coordination, healthcare collaboration, medical education

Your Medical Team is Changing, Whether You Like It or Not

Posted by Lawrence Kerr on Tue, Jul 31, 2018 @ 07:00 AM

rawpixel-577480-unsplashOne of my favorite parts of medicine is the experience of working across the continuum of care, with providers from a variety of backgrounds. Certainly, colleagues like nurse practitioners and RNs are deeply valued but people like orderlies and administrators are also passionate parts of the healthcare system that form key parts of the team. 

In my practice, one of the most successful parts of the what we did was to demonstrate in word and action that every single person, who is part of the medical team, is deeply valued and has a unique contribution that only he/she can bring. This approach was brought into our lauded Cranio-facial Team, as well, through which providers from social workers to plastic surgeons to oral surgeons, each of whom collaborated on complex cases like cleft palate and cleft lip care. In short: much of the richness I find in medicine comes from the diversity in our medical teams. 

That said, it can feel unmooring or even alarming to notice the ways that our medical teams are changing, especially when it comes to a relative decrease in the importance of physicians and the boom in numbers of providers like nurse practitioners. 

A recent article in the New England Journal of Medicine, Growing Ranks of Advanced Practice Clinicians — Implications for the Physician Workforce, looks at the boom in advanced practice registered nurses (APRNs), relative to the almost imperceptible growth of physicians in the US.

To start, one simple fact stood out to me: “Throughout the history of modern medicine, physicians have made up the vast majority of professionals to diagnose, treat, and prescribe medication to patients.”  This, of course is changing. An increasing part of healthcare is done by advanced practice registered nurses (APRNs), including nurse practitioners and physician assistants. Even with the current numbers, 41% of physicians work with nurse practitioners.

While the number of physicians in the US is growing very slowly (projected at 0.5% per year 2016-2030), the number of APRNs is growing quickly. Training times for these providers are shorter and there are fewer institutional constraints. The article authors did a rigorous projection of expected physician growth alongside expected APRN growth, based on census data, growth rates, and other key data. The result is that comparing 2001 to 2030, the percentage of APRNs relative to the pool of providers and APRNs together will go from 13% to 35%.

As doctors, we can bemoan these changes. We are all too familiar with the depth and rigor of the training we’ve received and it’s hard to fathom how an APRN can provide care that is as good as training that is less sophisticated.

But the reality is that, as the study authors assert, "These dynamics will have lasting effects on the composition of the health care workforce and working relationships among health professionals.”  Our medical team is changing -- our choice is how we adapt our work so that our medical teams can be as effective and satisfying to us as possible. 

The authors state unequivocally that “The changing composition of the workforce will have implications for provider teams.”  They point out that primary care providers are tending to work in larger groups with varying backgrounds and types of training. But this doesn't always go smoothly. Alarmingly, a recent study of NPs and physicians working on primary care teams “found that physicians, other staff, and patients often confused the roles and skills of various providers and that these misunderstandings often led to practices undermining the productivity and efficiency of NPs.”

This is where I believe my colleagues who are innovating in the field of care coordination, medical collaboration, and hybrid store-and-forward telemedicine have some crucial insights to share. By using telemedicine-supported healthcare collaboration, we fundamentally change the orientation of medicine from a sole provider giving the best care she can to a team of providers offering the best care they can. If we are individual providers working on our own, APRNs are a threat to physicians, and vice versa. Further, their very existence muddles things, creating confusion in care plans and complicating care coordination. In many instances, this is how things are right now.

On the other hand, if we have a consistent system to use telemedicine-based healthcare collaboration to work as a team -- like iClickCare -- then APRNs and physicians can work together smoothly, each contributing his/her unique perspectives in a way that doesn't detract from the work of the other. 

And ultimately, that's a more satisfying, effective, easeful way to work, regardless of what the healthcare landscape looks like now, or in the future.

You can try iClickCare without cost or implementation challenges. Get it free here:

Try the iClickCare 14-day evaluation

Tags: nurse practitioners, care coordination, telemedicine technology, Physician Assistant, healthcare collaboration software

Hospital Consolidation May Not Improve Data Sharing or Interoperability

Posted by Lawrence Kerr on Thu, Jul 26, 2018 @ 07:00 AM

helloquence-61189-unsplashThere has been an increasing trend towards consolidation in the healthcare field. Hospital systems buy other hospital systems, with the promise of cost-savings, improved results, and better data-sharing and interoperability.

In many ways, this is common sense. If we’re all part of the same organization, or even under the same roof, it stands to reason that we will be able to share data and collaborate more effectively.

Unfortunately, though, this doesn’t appear to be the case.

Using data from the 2014 American Hospital Association (AHA) annual survey and the 2015 IT supplement that included more than 2,000 hospitals, researchers found that consolidation enough wasn’t enough to improve interoperability.

In fact, it took several additional circumstances for interoperability to improve: centralized organizational governance, a specific business model, and an integrated insurance offering. 

Of course, achieving interoperability and data sharing is a hugely complex endeavor that can take time to come to fruition. It's not a race, and there are many precautions and complications that arise.

That said, I find it fascinating that even merging with another organization doesn't necessarily make it more streamlined for healthcare providers to collaborate, for data sharing to happen, or for interoperability to be a reality. 

My take on why? I believe that true data sharing and healthcare collaboration only come about through intention and through workflow changes on the part of healthcare providers. Yes, the organizational structure affects it. Yes, EHR interoperability plays a role. Yes, being under the same roof can make collaboration simpler than being in separate buildings. But ultimately, healthcare collaboration comes down to the choices that individual healthcare providers make. It's the choice to ask a question of a colleague, regardless of how that question gets asked. 

That's why we're so passionate about hybrid store-and-forward telemedicine® (like iClickCare) as a tool for healthcare collaboration. It doesn't require being under the same roof, or in the same organization, or even using the same EMR/EHR to collaborate, share information, and coordinate. It doesn't require that everyone in your organization use it or that everyone is "on board."  It just requires a 30-second download and then as-you-have-time consults with colleagues. Everything is archived so you can find it later -- and it won't conflict with your EHR. 

The above study certainly demonstrates that we can't wait for large structural shifts to practice medicine in ways that we think are right, and useful. We have access to the tools and structures we need now -- it's just a matter of acting on that.

 

Try the iClickCare 14-day evaluation

Tags: hybrid store and forward medical collaboration, care coordination, EHR

Migrant Children Highlight a Care Coordination Problem We All Have

Posted by Lawrence Kerr on Wed, Jul 25, 2018 @ 07:00 AM

chinh-le-duc-132753-unsplashOne truth that we don't acknowledge often enough is that the healthcare system often depends on caregivers to coordinate care. True, we have other members of the care team who do care coordination also, and we have tools that help us, but in many situations, it is the patient's caregiver that is doing the bulk of the caregiving. 

Healthcare depends on caregivers remembering care history, advocating for providers to collaborate, and reminding providers of key conditions when that information gets lost in the shuffle. This becomes exponentially more true, the more chronic, complex, or multidisciplinary a patient’s situation is.

The truth, of course, is that this isn’t always possible or feasible. Some patients don’t have an advocate or caregiver that is able to play this coordinating role. We do have team members like social workers and patient advocates, but sometimes the coordination of the care itself falls between the cracks.

I realized recently that there is an extreme case in which patients don't have a solid medical history and don't have a dependable caregiver able to coordinate care on their behalf. The situation is the medical care provided to the migrant children separated at the US border. It's interesting because it highlights the dangers inherent in the medical system for someone who might not have the same social supports and networks as many patients do.

A recent article in the New York Times looked at the situation in New York City, in which providers at public hospitals are seeing children who were detained at the border and separated from their parents. Brought in by foster parents, “The children who come in with medical issues such as asthma are without adult family members who can provide medical history.”  Further, therapists are endeavoring to provide emotional care for the children, along with the fact that they’re in the midst of an ongoing traumatic experience.

It's an obviously challenging situation and both foster families and healthcare providers are scrambling to help. But the broad strokes of the care don't different significantly from anyone without family to help, or caregivers to coordinate. These situations expose the cracks and weaknesses that affect all patients.

The truth is that to truly provide excellent care to all patients, we as healthcare providers need to be able to do care coordination and healthcare collaboration without the support of caregivers and family. We must identify and develop the tools we need to make this possible -- to allow us to communicate across the medical team, access key medical history, and consult with other providers efficiently and appropriately. The stakes are simply too high not to. 

 

ClickCare Quick Guide to Medical Collaboration

Tags: medical collaboration, care coordination, healthcare collaboration

New Pay Structures May Make It Harder to Care for Poor Patients

Posted by Lawrence Kerr on Thu, Jul 19, 2018 @ 07:00 AM

matt-collamer-555626-unsplashCaring for everyone has always been a core part of our practice of medicine.

Whether or not you can pay, and the complexity of your condition (medical or social) has never been a factor in whether we are willing to treat you, or in the quality of care you receive. 

In both of our community medical practices — Cheryl as a pediatrician and Larry as a reconstructive surgeon — this is just how we’ve done medicine, and it’s been a core part of what we did from the beginning. It’s not that we make money during our regular practice and then volunteer for the “disadvantaged” a few weeks per year — rather, we know that no one gets truly great care if a doctor is picking and choosing who to care for. The slope of that line of thinking is simply too slippery.

The truth, though, is that caring for people in this way used to be easier.

It’s certainly not impossible now. But taking payment from a patient in the form of chicken eggs (if that’s what they had to pay with) is almost impossible given the insurance and regulatory context we’re currently in. And that used to be somewhat frequent in my practice. Furthermore, the tools and workflow structures that orchestrate our day generally work against thoughtful, deep, individualized work with patients — driving us towards testing and diffusion of responsibility and fast, solo decisions.

So I do think that an article that came out in the New York Times recently is an important one.

Overall, the author, Dr. Dhruv Khullar, makes the point that “Doctors who care for disadvantaged populations need more resources to produce comparable health outcomes, but they’re less likely to have them.”  Further, that the current drive toward a fee-for-performance system is going to deeply dis-incentivize care of patients who have especially complex social, emotional, or economic needs. In a fee-for-service system, there are many inappropriate incentives — but at least doctors are compensated fairly for patients who have external circumstances demanding more time.

I think this perspective, in which we consider how new structures will affect all of our patients, is important. It’s not discussed enough, though. That said, I also worry that the framework of the discussion has some flaws. First, the framing of some patients as "poor / disadvantaged / complex" and others as "wealthy / straight forward" neglects to acknowledge that on any given day, even the wealthiest among us may experience complex social or economic constraints that make them the complex patient. Further, the truth is that the richness of our healthcare practice comes from treating all patients to a single standard  not to dividing up and choosing our standard of care (or who we treat) in any way.

Second, I believe that medical providers should view the imperatives of good medicine as outside of  and above  any fluctuations in payment or even workflow tools. We are each responsible for the hippocratic oath we took; we are each responsible to the human being sitting in front of us. It is up to us to find or create the tools and structures we need to do medicine in the ways that our conscience demands. 

That's why we believe so strongly in our work with iClickCare. The healthcare providers who use iClickCare to do healthcare collaboration, to improve medicine, to make their workday more satisfying do so because it's important to them  and they need wait for no one to start using it. It's affordable enough, and the ROI is so extreme, that it is a choice we can each make, on behalf of our patients  without anything else structural changing at all. 

You can try iClickCare today, for free, here: 

Try the iClickCare 14-day evaluation

Tags: good medicine, healthcare collaboration

Long Term Care Staffing Woes Demand Care Coordination

Posted by Lawrence Kerr on Tue, Jul 17, 2018 @ 07:00 AM

eberhard-grossgasteiger-255502-unsplashLong Term Care is complex — and it’s no secret that providers have long been doing a lot with a little — providing the best care they possibly can, with limited resources.

The nurses, aides, and other healthcare providers are generally committed, savvy, deeply caring people who provide sophisticated care to people with chronic conditions. And, usually, they receive less support than they should from the broader medical community. Our Long Term Care colleagues report feeling more isolated than they'd like to. 

So, a new report by the New York Times felt a bit blindsiding for our colleagues in the community. 

According to the piece, “Most nursing homes had fewer nurses and caretaking staff than they had reported to the government for years, according to new federal data.” A spotlight was put on facilities that could possibly be "gaming" the Medicare system by over-reporting staffing. And a serious look was given to facilities that have provider shortages on nights and weekends  a serious potential cause of issues like falls.

These issues are serious. And the reality is that skilled nursing facilities need oversight, especially because of the population they serve. These issues certainly shouldn't be downplayed or minimized. As David Stevenson, an associate professor of health policy at Vanderbilt University School of Medicine commented, “Volatility means there are gaps in care. It’s not like the day-to-day life of nursing home residents and their needs vary substantially on a weekend and a weekday. They need to get dressed, to bathe and to eat every single day.”

That said, this New York Times article is written like an exposé. It's written as if the nursing facilities are trying to “pull one over” on Medicare and the public. And, surely — some facilities probably are being dishonest in how they run. But most are trying to do the best possible work they can in an era when there is a shortage for great providers.

For instance, the New York Times references David Camerota, Chief Operating Officer of Upstate Services Group, who said that many nursing homes are in "a constant battle to recruit and retain employees even as it has increased pay to be more competitive."

In our opinion, Long Term Care and skilled nursing facilities would improve more by being offered better tools and more support  rather than more oversight or more scrutiny. We've found that hybrid store-and-forward telemedicine can be transformative in supporting providers in connecting with collaborators outside the walls of their institution  effectively amplifying the manpower of their healthcare providers. When there is a dearth of healthcare providers, care coordination becomes essential. For someone who may be caring for more patients than they should, the ability to ask a question of a specialist or an RN, regardless of the time of day, can mean the difference between a great outcome and a sad one.

Further, in addition to the substantive impacts on patient care, a tool like iClickCare can be powerful for lessening the sense of isolation and alienation that overworked Long Term Care providers can feel. And ultimately, that sense of connection is what we all need  the providers and the patients, alike.

 

ClickCare Quick Guide to Medical Collaboration

 

 

Tags: long term care, care coordination, healthcare collaboration, skilled nursing facility

The Opioid Epidemic Can't Be Solved Without Healthcare Collaboration

Posted by Lawrence Kerr on Thu, Jul 12, 2018 @ 09:15 AM

freestocks-org-126848-unsplashWe're all aware of the opioid epidemic in the United States.

We've seen the tragic photos of lives ripped apart. We've scanned the news describing the huge dollar amounts committed to resolving the problem. And we've experienced the complexities of treating an opioid abuser as healthcare providers.

But the truth is that our approach to care, treatment, and policy around this disease is lagging behind the realities of the epidemic. And as healthcare providers, we play one of the most important roles in preventing and treating the disease -- and caring for its sufferers.

Certainly, there are bright spots when it comes to the opioid epidemic. As Fierce Healthcare reports“Data from the Medicare Part D program show fewer beneficiaries are receiving high amounts of opioids, but a watchdog agency says usage 'remains concerning,' while urging insurers to further restrict at-risk patients with lock-in programs. However, 1 in 3 Part D beneficiaries still received at least one prescription opioid, and the overall level of opioid use 'continues to raise concerns.'"

Chemical dependency is not solved by other chemicals.  In the long term, many changes are needed and extensive, ongoing support is vital.  This includes the extreme burden placed on the providers themselves. Dependency is not an inpatient disease. It is not an outpatient disease. It is not family therapy. It is not joblessness, nor hopelessness. It is pervasive and knows no time schedule. It is difficult to treat for the provider, and a lifelong challenge for the patient.

If there was ever a time and need for universal healthcare collaboration across the entire spectrum of providers, patients and families, it is now, with this disease.

A single episode of failed access, of telephone tag, or of failure to educate –– results in the crashing down of years of rehabilitation. But who has the time or resources or skills to be available everywhere, for everyone, all the time?

A dramatic, gripping, thoughtful, and open Perspective piece in the New England Journal of Medicine by Audrey M. Provenzano, M.D., M.P.H., once read, becomes nearly haunting. She describes her feelings about caring for a patient with addiction:

“Already overwhelmed, I did not want to take on patients with needs that I did not know how to meet.”  She finishes the essay with a sentiment common to all who practice medicine: “I wish that I’d listened more closely. I wish that I had not been afraid.”

Dr. Provenzano articulates beautifully the loneliness and isolation a healthcare provider can feel in treating such a complex, multifaceted disease. Yes, a tool like iClickCare can smooth and facilitate the healthcare collaboration that bring many types of services and providers into one case. But perhaps equally importantly, a tool like iClickCare can alleviate the loneliness and isolation that the providers themselves feel. And that's not just a "nicety." That's a core part of ensuring sustainable care for the patients they are treating. 

As a company, we're finding ways of contributing to the opioid epidemic, using hybrid strore-and-forward telemedicine to facilitate the complex care needed. And as fellow healthcare providers, we certainly stand with the providers on the front lines of navigating this care every day.

If you're facing complex patients or opioid abuse in your practice, try iClickCare as one of your tools: 

Try the iClickCare 14-day evaluation

 

 

Tags: hybrid store and forward medical collaboration, healthcare collaboration, medical collaboration tool

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